Lead removal

I recently had my 3rd PM surgery during the last 15 months due to a fractured lead. Naturally, my regular surgeon was on vacation and his backup did the surgery, but was unable to remove the old lead. Then during my last checkup my EP said I might want to think about having the old lead removed due to my age(37). Is it possible to run out of areas to implant the leads.

Thank
You

tim

2 Comments

leads

by Tracey_E - 2009-08-27 07:08:52

Yes and no. First they try to fit the new lead on top of the old one. If they can't fit more, they try to extract. If they can't extract, they can do leads that go on the outside of the heart. So, yes, you can run out of room theoretically but there are a lot of options before that happens.

It depends on the size of your veins, the elasticity and the build up of scar tissue. If you've only had it 15 months, loss of elasticity and scar tissue isn't an issue. After the first year, they usually have to do an extraction to remove old leads, before that sometimes they can pull them out. You can generally can fit 3, occasionally 4, leads in before you need to think about extraction.

I have no idea why he'd say remove it due to age, they usually just leave it in there. There are downsides to leaving it in there (build up around it) but extraction is invasive and not without risk. I am 42 and have had a pm since I was 27. I have a bad lead now and will have it replaced when I get my next battery. We're going to try to add the new lead on top of the old ones, extraction is only a last resort if they can't fit it.

I think this depends..

by turboz24 - 2009-08-27 10:08:51

My EP generally removes the leads instead of leaving them. I have heard him mention that if you are older and he doesn't think you will survive an extraction, he will leave them, though.

I was going to say 3-4, but then the vein starts to get stuffed and the valves will probably leak more than you would want with all those cables going through them.

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